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Severe aplastic anemia preceding acute lymphoblastic leukemia
Y H Matloub1, R D Brunning, D C Arthur
1Division of Pediatric Hematology-Oncology, University of Minnesota, Minneapolis.
Cancer
|January 1, 1993
Summary
A rare case of acute lymphoblastic leukemia (ALL) developing 15 months after severe aplastic anemia, without blood count recovery, is presented. This differs from typical cases where ALL follows brief aplasia and blood count normalization within 6 months.
Area of Science:
- Hematology
- Oncology
- Pediatric Hematology
Background:
- Bone marrow aplasia preceding acute lymphoblastic leukemia (ALL) is uncommon, typically affecting children.
- ALL usually develops within 6 months after aplasia, following recovery of normal blood counts.
Observation:
- A unique case of severe aplastic anemia followed by ALL after a 15-month delay without blood count recovery is detailed.
- Literature review identified 23 cases of ALL following aplasia or hypoplasia with pancytopenia.
Findings:
- Most reported patients were young girls (≤10 years) with prevalent fever, potentially infectious.
- Typical ALL onset post-aplasia occurs within 6 months and after blood count recovery.
Implications:
- This case challenges the typical timeline and pathophysiology of aplasia-associated ALL.
- Potential causes include two unrelated disorders or a two-step leukemic process post-stem cell insult, possibly linked to antecedent hepatitis A.